STAMPED & REDACTED - FOR AGENDA ATTACHMENT - EMS LINQ, LLC.PDF

Office of the Maricopa County
School Superintendent

Steve Watson

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA)
SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 09/24/2024

Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next
available Board agenda.

The attached item(s) have been researched to ensure that the warrant(s) in question have not been
cashed or previously re-issued.

The original warrant(s) have had a stop payment done.
If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or

via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100.

Thank you

District Payee Warrant # Amount

Osborn Dist #8 EMS Ling, LLC 3700783736 | $10,286.60

Date

Amount

Reissue WT #

Office of the Maricopa County

Schoo! Sugperinienden?

Warrant Void/Stop Request

District Name / Number: Osborn School District #8

Contact Name: Yyonne Lopez

Attachments:
[| Original Warrant
Lost Warrant Affidavit (required for ALL reissues)
[| Vendor Letter (if requesting Vendor reissue)

Weorrant Number Warrant Date | Amount Payee = a .o
[starting with “37°) (mm/dd/yyyy) {as it eppears in Check Manager) 2 & 3
3700783736 | 7/19/2024) $ 10,286.60 EMS LINQ, LLC

Notes:

Lost in mail-never received. Please reissue.

District rovrorle Di pure ) . \ansyo

Date: AI Z\2K

Por Internal Use Onty
Clerk of Board Date:

Void Report Date:

Schools Affidavit/Claim Form —

Application for a Duplicate Warrant/Check (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction shaet which is page 2 of this form.
EMS LINQ, LLC (1), being first sworn, upon oath deposes and says:

Name/Clalmiant

On or about 7/16/2024 _ (date)(2) a warrant/check was issued to the
above named person/entity in the amount as stated below. Such warrant/check was
either never received or was subsequently inadvertently lost or destroyed and there is
no reasonable probability of its being found or presented for payment, or It was not
presented for payment within one year after the date of issuance,

Therefore, under penalty of perjury, claimant hereby affirms that this claim Is correct
and the amount shown ig due and owing, and the applicant requests that a replacement

warrant/check be Issjted to him/her in the sum of $ 10,286.60 (3)

Signed: ate Laderichs (4)

Toate

(5) Subseribed ’nd sworn to be this (ath day of glendae.< yas 0 :
aA ( RR

SP ession Bo %

NOTARY Prey J 5 i fs Ovary a

My cop my ssion expires: | es eres
mT “4 OVER oe

VOTE

PTT AT

Note, Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

(if known) (6)

Original Date of Issue
9 (if known) (7) 7/4 6/2024

Reason for origina! issue of Warrant/Check (8):
O Payroll

For Services or Goods furnished EMS LINQ, LLC
Other; EMS LINQ, LLC

S:\PROCESSES\Warrants - Oupiicate or Stale\O2 Forms\School

Revised June 2015 9/24/24

GE

o Ned
SCHOOL EXPENSE WARRANT Pe . ot 00 18373 6 N
TREASURER OF MARICOPA COUNTY

a

Me

. 91-3t1221 ¢
PHOENIX, ARIZONA DATE MARKED “BISUFFICIENT FUNDS’ DATE “CONTROL No, a

INTEREST STOPS CH DATE FUNDS AVAILABLE. (SEC 11. 636, ARSI0S3: t |

07/19/2024 8849788 | : '
OSBORN ELEMENTARY SCHOOL DISTRICT #8 _ __ é
. WARRANT AMOUNT f

PAY: a

“Ten Thousand Two Hundred Elghty Six and 60/100** Dollars $10,286.60 2
‘ VOID AFTER 366 DAYS CSE
TO EMS LINQ, LLC “a . {
ont P| ‘a ——
ORDER ay :
OF r 3 perinarent a} 8s i

MARICOPA COUNTY SCHOOLS « PHOENIX, ARIZONA 07/19/2024 Check: 8849788 EXPENSE
: . AP 20240724 —_ __ 3700783736
EMS LINO, LUC | . |_ 07/49/2024 | |
Payee / | / | Check Date | __ 1 ~ |
Account Number PO Number Invoice Amount —
250222 G-128541 10,286.60
\
VOUCHER: 7003 TOTAL: $10,286.60

HARLAND CLARKE 422892 30405532

9/23/24

To whom this may concern,

This letter is to support the fact that we, EMS LINQ, LLC have not received Warrant/Checkii
3700783736 which was issued on 7/16/24 in the amount of $10,286.60.
RE: State of Arizona County of Maricopa

The payment was intended for Invoice # C-128541 Osborn Elementary Schoo!
To help avoid further escalations which could lead to service interruptions we need this
situation rectified, as this Invoice is now 54 days past due.

Please note our remittance address is:
EMS LINQ

| would also like to note that | am the SR AR Analyst and the signer of the Affidavit Is our
representative.

’ Should you need any additional information to help with resolution, please contact me i
directly, as it will be my pleasure to assist. i

Sincerely,

9/24/24, 1:08 PM
Warrant (1 - mcto) - Warrant number 3700783736, Stopped

Veit Warrant | Status

Print | Attachments

VMware Horizon

Setup | Attachments jo

Y
___ Maintain New Status
3700783736
4 Warrant header —_
General
Warrant number:
Holder:
Issued date 1/19/2024
Status: Stopped
Exception flag: i]
Exception reason: None
Queued for positive pay: j-"1
Locked forreconcile: = |]
Registered
Date registered:
No of days interest: Dp)
Annual interest rate:

0,00000
“a Warrant Lines —

C1 Amount ; Payee
10,286.60 EMS LINQ, LLC

12:00:00 am

Posting
Invoice:
Invoice date:
Paid date;

Positive pay sent date: 7/24/2024

Agency details

Agency voucher number 7003
Agency claim number:
Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept num:

99:00:05 am

Account

Id 2

& bl | rol | §) | identification of the warrent

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